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The COVID-19 pandemic has placed enormous pressure on healthcare systems. In the first line of the “war” against the virus, hospitals tried to maintain their general operations, while supplementing their services with COVID-19 patient care. To tackle the new difficulties, hospitals had to develop strategic response plans, and were in need of finding the most effective management structure for their institution. The focus of this paper is the aforementioned management structures. After overviewing the international literature, we identified three different approaches and we named them the Horizontal, Vertical, and Intermedier Approach. The separation is based on the following features: decision making, information distribution, command forwarding, intra-hospital communication channels, hierarchy, and control. After summarizing the international experiences, we introduce a Hungarian centrum hospital’s approach, as the institution was assigned to fulfil COVID-19 centrum hospital duties in the middle of the first wave. The North-Buda Szent János Central hospital was in need of restructuring their management structure, and the leadership decided to transform it into a hierarchical, vertical structure, operating with centralized decision making and personal control. This control–command system idea came from the hospital’s Internist Head Coordinator Physician, who is the first author of our article, and had serious military medicine experiences (in Afghanistan).

Obesity again has become the center of attention due to its growing incidence experienced in the last decade and its strong coherence to cardiovascular diseases. Especially abdominal obesity together with dyslipidemia featuring hypertonia, hyperglycemia, high level of triglycerides, and low level of HDL3 cholesterol accounts for cardiovascular risks. The independent and comprehensive term metabolic syndrome is used for their frequent collective occurrence and combination. In the past years, the term cardiometabolic risk was created by considering other cardiovascular factors besides the components of the syndrome. Increase in the number of the obese was observed in military organizations worldwide, too. Parallel to obesity, there is a growing number of both professional and contracted servicemen in the Hungarian Defence Force exposed to the increased danger of cardiometabolic disease according to the metabolic syndrome criteria's. The efficient reduction of cardiometabolic risk is possible with appropriate prevention strategies. The population's primary and secondary prevention starts in primary care with the involvement of family doctors, but it is also a fundamental responsibility in the military healthcare system in order to preserve a force fit to fight. [ABSTRACT FROM AUTHOR]